SNARESBROOK PRIMARY SCHOOL
Meadow Walk
South Woodford E18 2EN
Tel No: 0208 989 9975
FOR SCHOOL USE ONLYBirth certificate / Passport / Birth certificate or passport number
School roll updated / Visit date / Class
ADMISSION FORM FOR NURSERY AND PRIMARY SCHOOL
Please provide birth certificate. This must be provided before a place is given.
PART A: CHILD’S DETAILSSURNAME …………………………………….FIRST NAMES ………………………………………………
DATE OF BIRTH: ………………………AGE: ……………………….. yrs ………….…… months
ADDRESS:……………………………………………………………………………………………………
…………………………………………………………………….….POST CODE ……………………….
Sex: Male Female UPN (if known) ………………………..………………………...
PREVIOUS SCHOOL (if applicable) ………………………………………………………..…………
SCHOOL ADDRESS:………………………………...………………………………………………………
………………………………..……. POST CODE ………………TEL ……………………………………
OTHER CHILDREN IN THE FAMILY
Name / Date of Birth / School
1.
2.
3.
4.
WHO DOES THE CHILD LIVE WITH?
Please tick as appropriate:
Mother and Father
/Mother and Stepfather
Mother
/Father and Stepmother
Father
/Guardian
Foster Parent
/Other
Who should correspondence be sent to:Email address you wish the school to use:
Other person/s with legal parental responsibility:
Relationship to child:
MOTHER’S/STEPMOTHER’S SURNAME:
FORENAME: / MRS / MS / MISS / OTHER (Please state)
Home address (if different from above)
Home telephone number: / Mobile number:
Place of work
(if applicable): / Work number:
Times and days of work:
FATHER’S/STEPFATHER’S SURNAME:
FORENAME: / MR / OTHER (Please state)
Home address (if different from above)
Home telephone number: / Mobile number:
Place of work
(if applicable): / Work number:
Times and days of work:
GUARDIAN’S SURNAME: / FORENAME:
FORENAME: / MR / MRS / MS / MISS / OTHER (Please state)
Home address (if different from above):
Home telephone number: / Mobile number:
Place of work
(if applicable): / Work number:
EMERGENCY CONTACTS. In the case of an emergency and we are unable to contact mother/father/guardian, we need emergency contact numbers. These can be relatives, neighbours, friends etc. in the order you prefer us to use - we will try to use them in order, however we may use any if we need to contact you. Only use mobile numbers if they will be SWITCHED ON ALL DAY
1. Name………………………………………………….. Relationship …………………………………
Tel: ……………………………………………….. Mobile: ………………………………………………2. Name………………………………………………….. Relationship …………………………………
Tel: ……………………………………………….. Mobile: ……………………………………………..3. Name………………………………………………….. Relationship …………………………………
Tel: ……………………………………………….. Mobile: ………………………………………………4. Name………………………………………………….. Relationship …………………………………
Tel: ……………………………………………….. Mobile: ………………………………………………PLEASE INFORM US IMMEDIATELY IF THESE NUMBERS CHANGE – BY EMAIL, PHONE OR FILLING IN A PUPIL UPDATE FORM FROM THE OFFICE
Please indicate how your child will travel to school TICK ONE BOX ONLYCar / Bus / Walk / Train/Tube
CULTURAL INFORMATION
RELIGION: / Tick / TickChristian / Sikh
Hindu / Greek Orthodox
Jewish / No religion
Muslim / Other (please specify)
All schools are required by the Department for Education and Skills (DfES), to record the ethnic background of children. Please study the list and tick ONE BOX ONLY to indicate the ethnic background of the child named above. If you do not complete this form, the school may use its best judgement to assess the ethnic background of your child, noting that the information has been arrived at in this way, rather than provided by you. The school will let you know this decision and you can ask that the ethnic background of the pupil be changed or removed.
WHITE
British / Gypsy/Roma / KosovanIrish / Greek/Greek Cypriot / White European
Traveller of Irish Heritage / Turkish/Turkish Cypriot / White Other
Please specify………………
MIXED
White and Black Caribbean / White and Asian / Other mixed background
Please specify ……………
White and Black African / Asian and Black
ASIAN OR ASIAN BRITISH
Indian / Pakistani – Kashmiri / Other Asian background
Please specify………………….…..
Bangladeshi / Pakistani - Other
Pakistani – Mirpuri / Sri Lankan Tamil
BLACK OR BLACK BRITISH
Caribbean / Somali / Congolese
African / Nigerian / Other Black background
Please specify………..……………..
Ghanaian / Angolan
CHINESE
/ANY OTHER BACKGROUND
Please specify………………………………………………….…I DO NOT WISH AN ETHNIC BACKGROUND CATEGORY TO BE RECORDED
NATIONALITY
Please specify the nationality of your child:………………………………………………………………………………
I DO NOT WISH THE NATIONALITY OF MY CHILD TO BE RECORDED
COUNTRY OF BIRTH
Please specify country of birth for your child:…………………………………………………………………………
I DO NOT WISH THE COUNTRY OF BIRTH FOR MY CHILD TO BE RECORDED
MOTHER TONGUE
If language spoken at home is not ENGLISH please specify what language is/are spoken: Tick one box only
CODE / DESCRIPTION / CODE / DESCRIPTION / CODE / DESCRIPTION
AKA / Akan /Twi-Fante / HEB / Hebrew / SER / Serbo-Croat
AKAF / Akan (Fante) / HIN / Hindi / SIN / Sinhala
AKAT / Akan (Twi-Asante) / IGB / Igbo / SOM / Somali
ALB / Albanian/Shqip / ITA / Italian / SPA / Spanish
AMH / Amharic / JAP / Japanese / SWA / Swahili/Kiswahili
ARA / Arabic / KOR / Korean / SWAA / Swahili (any other)
BEN / Bengali / KUR / Kurdish / SWAC / Comorian Swahili
CHI / Chinese / LIN / Lingala / SWAK / Swahili (Kingwana)
CRE / Creole(English) / LUG / Luganda / SWAM / Swahili (Brava/Mwiini
CRF / Creole (French) / NOR / Norwegian / SWAT / Swahili(Bajuni/Tikuu)
DAN / Danish / OTH / Other / SWE / Swedish
DUT / Dutch / PAN / Panjabi / SYL / Sylheti
ENG / English / PAS / Pashto / TAG / Tagalog
FAR / Farsi / POL / Polish / TAM / Tamil
FIN / Finnish / POR / Portuguese / TUR / Turkish
GER / German / RMN / Romanian / UNK / Unknown
GRE / Greek / RMNM / Romanian(Moldova) / URD / Urdu
GUJ / Gujarati / RMNR / Romanian (Romania) / VIE / Vietnamese
FRE / French / RUS / Russian / YOR / Yoruba
If other please specify:
OTHER
Are you an Asylum Seeker? / YES / NODate of arrival in the U.K.
Do you currently receive Free School Meals entitlement: / YES / NO
If yes, you will need to provide us with a copy of the Authorisation of Free School Meals form. Please bring this into the office with your other required documentation.
MEDICAL INFORMATION
NAME OF FAMILY DOCTOR ……………………………………… TEL ………………………….ADDRESS ………………………………………………………………………………………………..
Please tick any of the following that apply to your child:
Tick / Tick
Wears glasses / Hearing impairment
Suffers from epilepsy / Food allergies
Hay fever / Other allergies (e.g. plaster)
Asthma / Diabetic
Any other medical condition we should know about for the safety of your child, with details:
If your child will need to take any regular medication in school, a health care plan will need to be completed. Please specify any medication he/she needs to have in school
Permission to administer First Aid: / Yes / No
Permission to telephone Doctor: / Yes / No
Any special dietary requirements (e.g. vegetarian, vegan etc.)
Are your child’s immunisations up to date? / Yes / no
Has your child had the MMR2 vaccine? / Yes / no Date given:
Has your child had the pre-school booster? / Yes / no Date given:
SPECIAL EDUCATION NEEDS Yes No
Has your child got a Statement of Special Educational needs?
Has your child been receiving any support for Special needs?
Please give details
PART B: CONSENT FORMS.
Please read the following carefully and complete the table on Page 7. Thank you.
1. CONSENT FOR PUBLICATION OF PHOTOGRAPHS
Occasionally, Snaresbrook Primary School may invite members of the press to cover special occasions, concerts etc. The local newspapers also like to come into school to take class photographs of the new reception children. Photographs may also be taken by staff members for use within school, e.g. of class activities, members of the school council etc. The school will not use these photographs for publication on the internet. Please tick the box ‘consent given’ at the end of this form if you agree to your child’s photograph being taken by the school or the press, and for the use of this within the school or for publication.
1a. CONSENT FOR PUBLICATION OF NAMES
While reporting on special events, or together with a photograph, the press sometimes like to publish the names of the children involved. Please tick the box ‘consent given’ at the end of this form if you agree to your child’s name being published.
2. SHORT WALKS AROUND THE LOCAL AREA
The National Curriculum involves the children exploring their local environment at different stages of their school life. It would be helpful to be able to take them out of the school grounds, either in groups or as a class, with supervision. This would only involve an area within easy walking distance, e.g. the shops, and for a short time. This will include visits to the local places of worship as part of the curriculum. You permission will be sought separately for trips going further afield. Please tick the box ‘consent given’ at the end of this form if you agree to your child taking part.
By ticking ‘consent given’ to parts 2:
· I agree to my child taking part in local visits and non-hazardous day visits which may occur from time to time during the years my child is in attendance at the school.
· I understand that the school and the organisers will take all reasonable and proper precautions for the care and safety of my child and of his/her personal property. I also understand that the council and the organisers will only be responsible for any injury or loss of personal property if this is caused by negligence.
· I agree to inform the school of any relevant medical or other special circumstances affecting my child, including any treatment required during the course of the visit.
· I understand that if my child should need emergency medical treatment, every effort will be made to contact me before treatment is given. If, however, this is impossible I give my consent to my child undergoing emergency medical treatment by a qualified medical practitioner.
3. PROVISION OF FRUIT TO KS1 CHILDREN
Snaresbrook Primary School takes part in the Healthy Schools Scheme, which is a government initiative aimed at improving nutrition in schoolchildren. As part of this scheme, a piece of fruit is provided free of charge, every day, to all children from Nursery to Year 2. Please tick the box ‘consent given’ at the end of this form if you agree to your child being provided with daily fruit.
Please indicate here if your child is allergic to any fruit……………………………………………..
PLEASE INDICATE WHERE YOU DO/ DO NOT GIVE PERMISSION BY TICKING IN THE APPROPRIATE BOX TO THE RIGHT / CONSENT GIVEN / CONSENT NOT GIVEN1. PUBLICATION OF CHILD’S PHOTOGRAPH
Local Paper, School Website, Other Publications.1a PUBLICATION OF CHILD’S NAME
2. SHORT WALKS AROUND THE LOCAL AREA3. PROVISION OF FRUIT TO MY CHILD (NURSERY TO Y2 ONLY)
4. INTERNET PERMISSION FORM
I grant permission for my child to use electronic mail and the internet. I understand that pupils will be held accountable for their own actions. I also understand that some material on the internet may be objectionable and I accept responsibility for setting standards for my child to follow when selecting, sharing and exploring information and media.
This consent will cover the whole of your child’s education at Snaresbrook Primary School. However, if you do wish to withdraw your consent at any time, you may do so by informing the school office in writing.
The pupil date held on computer will be protected under the Data Protection Act 1984.
PLEASE REMEMBER THAT IT IS YOUR RESPONSIBILTY (AND ESSENTIAL FOR YOUR CHILD’S SAFETY) THAT THIS INFORMATION IS KEPT UP TO DATE.
Signed………………………………………………. Date……………………………..
Relationship to child…………………………………………………………………….
PLEASE KEEP FOR YOUR INFORMATION
School Communication App – Groupcall Xpressions
View your child’s information on your mobile phone!
An exciting new service is now available for parents to ensure communication between the school and yourselves is easier and more effective. Groupcall Xpressions is a new service created by the award-winning school communication company Groupcall Limited.
The app is completely free of charge to you and can be installed on your mobile phone or tablet. It currently supports both Apple iOS and Android devices (with Windows mobile to follow) and you’ll be able to see information for your children.
If you have children in different schools and those schools also use Groupcall Xpressions, you will be able to view information on multiple children within the same app.
What do I need to do now?
Once your child has started school you can download the app and register using the matching email address and phone number on this form. You’ll need to make sure you keep these details up to date in future to maintain access to the service.
What happens next?
Now Xpressions has been set up in school you will be able to see the following information for your child:
· Free messages sent by the school delivered directly to the app
· Notification timeline for the above.
More information…
More information can be found on the Groupcall Xpressions parent website - http://parents.groupcall.com/
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